中国血液净化

中国血液净化 ›› 2025, Vol. 24 ›› Issue (03): 214-217.doi: 10.3969/j.issn.1671-4091.2025.03.009

• 临床研究 • 上一篇    下一篇

血液透析中不同类型透析器预充量的测量

崔冬梅   宋 利   赵立艳   全梓林   胡宇航   梁绮祯   康小莉   冯仲林   尹 燕   

  1. 510080 广州，1南方医科大学附属广东省人民医院(广东省医学科学院)肾内科
  • 收稿日期:2024-06-03 修回日期:2025-01-15 出版日期:2025-03-12 发布日期:2025-03-12
  • 通讯作者: 尹燕 E-mail:yinyan1019@139.com
  • 基金资助:
    广东省医学科学技术研究基金项目(A2024441)；广东省医学科学技术研究基金项目(B2023011)

Measurement of priming volume for different types of dialyzers used for hemodialysis

CUI Dong-mei, SONG Li, ZHAO Li-yan, QUAN Zi-lin, HU Yu-hang, LIANG Qi-zhen, KANG Xiao-li, FENG Zhong-lin, YIN Yan   

  1. Department of Nephrology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China
  • Received:2024-06-03 Revised:2025-01-15 Online:2025-03-12 Published:2025-03-12
  • Contact: 510080 广州，1南方医科大学附属广东省人民医院(广东省医学科学院)肾内科 E-mail:yinyan1019@139.com

摘要： 目的  通过测量血液透析(hemodialysis，HD)不同类型透析器预充量，对比其与理论预充量的差异，为临床实践中透析器的预充剂量提供参考。 方法 对广东省人民医院2023年6月HD中心常用的9种不同型号干膜透析器的血室容量及HD管路容量进行测量。 结果 共收集9种不同型号的干膜透析器共31例次膜内预充数据，其中醋酸纤维素膜14例次，合成膜17例次。醋酸纤维素膜滤器所需生理盐水(normal saline，NS)预充量215.6(203.5,225.2)ml，合成膜滤器208.0(192.2,217.6)ml。合成膜滤器膜内湿化所需的NS量高于醋酸纤维素膜(Z=-9.181，P＜0.001)。醋酸纤维素膜滤器、合成膜滤器的测量预充量均低于理论预充量(t=-14.429、-13.339，均P＜0.001)。 结论  本研究所使用透析器测量预充量均小于说明书理论预充量，合成膜透析器预充时膜内湿化所需的NS量高于醋酸纤维素膜。

关键词: 血液透析, 透析器, 预充量

Abstract: Objective  In clinical practice, a pre-charge volume has to be administered during the machine setup to prevent rapid blood pressure drop after blood drawing for hemodialysis (HD). The theoretical blood chamber volume varies among different dialyzer models, which poses a challenge for clinical assessment of pre-charge volume. This study aims to measure the pre-charge volume of different types of dialyzers used in HD and compare with the theoretical pre-charge volume to provide a reference for the dosage of pre-charge in clinical dialyzers.  Methods  The blood chamber volume and HD circuit volume of 9 types of dry membrane dialyzers commonly used in the Hemodialysis Division of Guangdong Provincial People's Hospital in June 2023 were tested.  Results  A total of 31 pre-charge data from 9 types of dry membrane dialyzers were collected, including 14 instances with cellulose acetate membrane and 17 instances with synthetic membrane. The physiological saline (NS) pre-charge volume required for the dialyzers with cellulose acetate membrane filters was 215.6(203.5～225.2) ml and that required for the dialyzers with synthetic membrane filters was 208.0 (192.2～217.6) ml. The amount of NS required for the internal wetting of synthetic membranes was statistically higher than that of cellulose acetate membranes [118.0(96.4, 141.0) ml vs. 33.8(23.7, 47.5) ml, Z=-9.181, P＜0.001]. Overall, there was a significant difference between the theoretical pre-charge volume and the measured pre-charge volume for dialyzers with both types of membranes, with the measured pre-charge volume significantly lower than the theoretical pre-charge volume (t=10.270, P＜0.001); the measured pre-charge volume for dialyzers with cellulose acetate membrane filter was significantly lower than the theoretical pre-charge volume (t=-14.429, P＜0.001), and the measured pre-charge volume for dialyzers with synthetic membrane was also significantly lower than the theoretical pre-charge volume (t=-13.339, P＜0.001).  Conclusion  The measured pre-charge volumes of the dialyzers used in this study were all less than the theoretical pre-charge volumes suggested in the manuals, and the NS volume required for internal wetting during pre-charge was higher for synthetic membranes than for cellulose acetate membranes. The conclusions of this study provide a theoretical basis for the precise management of volume in hemodynamically unstable HD patients who require pre-charge before blood drawing treatment.

Key words: Hemodialysis, Dialyzer, Priming volume

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